Regionalization Patterns for Children with Serious Trauma in California (2005–2015): A Retrospective Cohort Study

Wang, N Ewen; Ewbank, Clifton; Newton, Christopher; Spain, David A.; Pirrotta, Elizabeth; Thomas-Uribe, Monika

doi:10.1080/10903127.2020.1733715

Cited by 3 publications

(2 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Second, we used an administrative data set, and thus the data is potentially subject to incomplete or erroneous input on the part of providers. However, the California Office of Statewide Health Planning and Development database has been used successfully in numerous population-wide studies 13,14,19,20 ; as such, we find no reason to expect such errors significantly skewed results in our study. Third, we used strict transfer criteria to ensure we captured the most accurate sample of transferred pediatric patients to further study their trajectories of care.…”

Section: Discussionmentioning

confidence: 56%

See 1 more Smart Citation

California Children Presenting to an Emergency Department for Mental Health Emergencies

Shearer

Wang

2022

Pediatr Emer Care

Self Cite

View full text Add to dashboard Cite

ObjectivesPediatric emergency department (ED) mental health visits are increasing in the United States. At the same time, child/adolescent psychiatric services are limited. This study examines the trajectory of pediatric patients presenting with mental health emergencies to better understand availability of specialty care resources in regional networks.MethodsThis retrospective cohort study used a California Office of Statewide Health Planning and Development linked ED and Inpatient Discharge Dataset (2005–2015) to study pediatric patients (5–17 years) who presented to an ED with a primary mental health diagnosis. Outcomes were disposition: discharge, admission, or transfer.Patients transferred were further analyzed for disposition. Regression models to identify characteristics associated with disposition were created.ResultsThere were 384,339 pediatric patients presented for a primary mental health emergency from 2005 to 2015; 287,997 were discharged, 17,564 were admitted, and 78,725 were transferred. Among those not discharged, patients with public (odds ratio [OR], 1.28; P < 0.01) or self-pay insurance (OR, 5.64; P < 0.01), Black (OR, 2.15; P < 0.01), or Native American race (OR, 2.32; P < 0.01), and who presented to rural EDs (OR, 3.10; P < 0.01), nonteaching hospitals (OR, 3.06; P < 0.01), or hospitals in counties without dedicated child/adolescent psychiatric beds (OR, 5.59; P < 0.01) had higher odds of transfer.Among those not discharged from the second hospital, Black patients (OR, 2.47; P < 0.03) and those who were transferred to a teaching hospital (OR, 1.9; P < 0.01) had higher odds of second transfer.ConclusionsPediatric patients with mental health emergencies experience different trajectories of care. Transfer protocols and regionalized networks may help streamline services and decrease inefficiencies in care.

show abstract

Section: Discussionmentioning

confidence: 56%

“…This was a retrospective cohort study using a California Office of Statewide Health Planning and Development linked ED and Inpatient Discharge Dataset from the years 2005 to 2015 13 …”

Section: Methodsmentioning

confidence: 99%

California Children Presenting to an Emergency Department for Mental Health Emergencies

Shearer

Wang

2022

Pediatr Emer Care

Self Cite

View full text Add to dashboard Cite

show abstract

Association Between Hospital Arrival Time and Avoidable Transfer in Pediatric Trauma

O'Guinn,

Martino,

Ourshalimian

et al. 2023

Journal of Pediatric Surgery

View full text Add to dashboard Cite

Does Trauma Center Volume Account for the Association Between Trauma Center Verification Level and In-Hospital Mortality among Children Injured by Firearms in California?

Sullivan

Reddy

Reiter

et al. 2023

Journal of the American College of Surgeons

View full text Add to dashboard Cite

BACKGROUND: Heterogeneity in trauma center designation and injury volume offer possible explanations for inconsistencies in pediatric trauma center designation’s association with lower mortality among children. We hypothesized that rigorous trauma center verification, regardless of volume, would be associated with lower firearm injury-associated mortality in children. STUDY DESIGN: This retrospective cohort study leveraged the California Office of Statewide Health Planning and Development patient discharge data. Data from children aged 0-14 years in California from 2005-2018 directly transported with firearm injuries were analyzed. American College of Surgeons (ACS) trauma center verification level was the primary predictor of in-hospital mortality. Centers’ annual firearm injury volume was analyzed as a mediator of the association between center verification level and in-hospital mortality. Two mixed effects multivariable logistic regressions modeled in-hospital mortality and the estimated association with center verification while adjusting for patient demographic and clinical characteristics. One model included the center’s firearm injury volume and one did not. RESULTS: The cohort included 2,409 children with a mortality rate of 8.6% (n=206). Adjusted odds of mortality were lower for children at adult level I (adjusted odds ratio [aOR]: 0.38, 95% CI: 0.19-0.80), pediatric (aOR: 0.17, 95% CI: 0.05-0.61), and dual (aOR: 0.48, 95% CI: 0.25-0.93) trauma centers compared to non-trauma/level III/IV centers. Firearm injury volume did not mediate the association between ACS trauma center verification and mortality (aOR/10 patient increase in volume: 1.01, 95% CI: 0.99-1.03). CONCLUSIONS: Trauma center verification level, regardless of firearm injury volume, was associated with lower firearm injury-associated mortality, suggesting that the ACS verification process is contributing to achieving optimal outcomes.

show abstract

Regionalization Patterns for Children with Serious Trauma in California (2005–2015): A Retrospective Cohort Study

Cited by 3 publications

References 18 publications

California Children Presenting to an Emergency Department for Mental Health Emergencies

California Children Presenting to an Emergency Department for Mental Health Emergencies

Association Between Hospital Arrival Time and Avoidable Transfer in Pediatric Trauma

Does Trauma Center Volume Account for the Association Between Trauma Center Verification Level and In-Hospital Mortality among Children Injured by Firearms in California?

Contact Info

Product

Resources

About